PMID: 16521073Mar 8, 2006Paper

From dialysate temperature to thermal balance

Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
F Pizzarelli

Abstract

The observations concerning the role of temperature in cardiovascular (CV) stability date back to the early 1980s. Since then, many studies have corroborated the original findings on the hemodynamic benefits of what is known as 'cold' as opposed to 'warm' or standard hemodialysis (HD). While the assumptions and conclusions remain fully valid, more recent experience has led to a review of the way the treatments have been defined. The fact that the patient gains or loses heat is not only the consequence of dialysis fluid temperature, but is the result of the interrelationships between dialysis-related factors and patient characteristics. Among the former, blood flow, arterovenous temperature difference in the extracorporeal blood, length and layout of the hematic lines, environmental temperature, and a possible cytokine-mediated pyrogenic effect are all factors that, directly or indirectly, can decisively influence the thermal balance of the dialysis session. Among the latter, the greater the ultrafiltration (UF) rate the greater the buildup of body heat. Finally, there is a considerable variability in body temperature within and between individual uremic patients, and it is especially the subgroup of hypothermic patients who ben...Continue Reading

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